*1.Problem- What is the process or program that doesn’t seem to be working like it should?

(Required.)

*2.Key Activities- What are the specific process or program steps that do not appear to be working?(Required.)

*3.Effects- What harm do these issues cause? What harm do these issues cause to the overall organization? How many wasted hours? How many unnecessary or redundant steps?(Required.)

*4.Scope- What level(s) in the organization is this process or program impacting?(Required.)

*5.Performance Metrics- How can the problem be measured?  What measures or results would show improvement?

(Required.)

*6.Timeline- How long has this been a problem? Will this problem persist into the future or is it linked to a one-time situation? (Required.)

7.Optional- So that we can better follow-up in case we need additional information, please provide the below contact information

Name

Organization

Email Address

Phone Number